Atenolol PO, NG
Acute myocardial infarction
Secondary prevention in patients with coronary artery disease
PO / NG:
Pacific atenolol: orange 50mg and 100mg tablets. Tablets may be crushed and administered via nasogastric tube.
Commence at 50mg daily; increase to 100mg daily as tolerated.
[Note: Metoprolol is the preferred as 1st line beta blocker rather than atenolol in our ICU]
Safety and effectiveness in paediatric patients have not been established
1-2mg/kg PO 12-24hrly.
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY
Dose in renal impairment [GFR (ml/min)]
<10 50mg once daily
10-20 dose as in normal renal function
>20-50 dose as in normal renal function
Dose in renal replacement therapy
CAPD 50mg once daily
HD 50mg once daily
CVVHDF dose as in normal renal function
Atenolol is a beta1-selective (cardioselective) beta-adrenergic receptor blocking agent without membrane stabilizing or intrinsic sympathomimetic (partial agonist) activities. This preferential effect is not absolute, however, and at higher doses, atenolol inhibits beta2-adrenoreceptors, chiefly located in the bronchial and vascular musculature. Absorption of an oral dose of atenolol is rapid and consistent but incomplete. Approximately 50% of an oral dose is absorbed from the gastrointestinal tract, the remainder being excreted unchanged in the faeces. Peak blood levels are reached between 2 and 4 hours after ingestion.
Heart block greater than first degree
Overt cardiac failure
Sympathetic stimulation is necessary in supporting circulatory function in congestive heart failure, and beta blockade carries the potential hazard of further depressing myocardial contractility and precipitating more severe failure.
Discontinuation of therapy
Discontinuation of therapy in a patient with coronary artery disease may lead to rebound angina, arrhythmia or myocardial infarction.
Diabetes and Hypoglycemia
Beta blockers may mask tachycardia occurring with hypoglycaemia.
Beta-adrenergic blockade may mask certain clinical signs (e.g., tachycardia) of hyperthyroidism. Abrupt withdrawal of beta blockade might precipitate a thyroid storm.
Atenolol may aggravate peripheral arterial circulatory disorders.
No tests in addition to routine ICU tests are required
Drug/Laboratory Test Interactions :
Beta blockers may exacerbate the rebound hypertension which can follow the withdrawal of clonidine
Body as a Whole:
Bradycardia , Cold extremities, Hypotension, Leg pain
Dizziness, Vertigo, Light-headedness